Risk of hip/femur fracture after stroke: a population-based case-control study
Risk of hip/femur fracture after stroke: a population-based case-control study
BACKGROUND AND PURPOSE: Stroke increases the risk of hip/femur fracture, as seen in several studies, although the time course of this increased risk remains unclear. Therefore, our purpose is to evaluate this risk and investigate the time course of any elevated risk. METHODS: We conducted a case-control study using the Dutch PHARMO Record Linkage System database. Cases (n=6763) were patients with a first hip/femur fracture; controls were matched by age, sex, and region. Odds ratio (OR) for the risk of hip/femur fracture was derived using conditional logistic regression analysis, adjusted for disease and drug history. RESULTS: An increased risk of hip/femur fracture was observed in patients who experienced a stroke at any time before the index date (adjusted OR, 1.96; 95% CI, 1.65-2.33). The fracture risk was highest among patients who sustained a stroke within 3 months before the index date (adjusted OR, 3.35; 95% CI, 1.87-5.97) and among female patients (adjusted OR, 2.12; 95% CI, 1.73-2.59). The risk further increased among patients younger than 71 years (adjusted OR, 5.12; 95% CI, 3.00-8.75). Patients who had experienced a hemorrhagic stroke tended to be at a higher hip/femur fracture risk compared with those who had experienced an ischemic stroke. CONCLUSIONS: Stroke is associated with a 2.0-fold increase in the risk of hip/femur fracture. The risk was highest among patients younger than 71 years, females, and those whose stroke was more recent. Fall prevention programs, bone mineral density measurements, and use of bisphosphonates may be necessary to reduce the occurrence of hip/femur fractures during and after stroke rehabilitation.
bone density, fracture, risk factors, stroke
3281-3285
Pouwels, Sander
f086c289-b173-4b02-b064-68a1f9ebf912
Lalmohamed, Arief
80b22329-8bc7-4ea7-bc5e-b97040e1186a
Leufkens, Bert
6676720e-9f2a-47e2-bad4-2d174b2fbdba
de Boer, Anthonius
18179869-03fb-447a-87bf-6d9f395c7dee
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Staa, Tjeerd
062ecdf4-b73c-47b3-ba9e-48aa0a47e519
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
2009
Pouwels, Sander
f086c289-b173-4b02-b064-68a1f9ebf912
Lalmohamed, Arief
80b22329-8bc7-4ea7-bc5e-b97040e1186a
Leufkens, Bert
6676720e-9f2a-47e2-bad4-2d174b2fbdba
de Boer, Anthonius
18179869-03fb-447a-87bf-6d9f395c7dee
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
van Staa, Tjeerd
062ecdf4-b73c-47b3-ba9e-48aa0a47e519
de Vries, Frank
10245a32-6083-4feb-9d20-7e7db0f358b1
Pouwels, Sander, Lalmohamed, Arief, Leufkens, Bert, de Boer, Anthonius, Cooper, Cyrus, van Staa, Tjeerd and de Vries, Frank
(2009)
Risk of hip/femur fracture after stroke: a population-based case-control study.
Stroke, 40 (10), .
(doi:10.1161/STROKEAHA.109.554055).
(PMID:19661475)
Abstract
BACKGROUND AND PURPOSE: Stroke increases the risk of hip/femur fracture, as seen in several studies, although the time course of this increased risk remains unclear. Therefore, our purpose is to evaluate this risk and investigate the time course of any elevated risk. METHODS: We conducted a case-control study using the Dutch PHARMO Record Linkage System database. Cases (n=6763) were patients with a first hip/femur fracture; controls were matched by age, sex, and region. Odds ratio (OR) for the risk of hip/femur fracture was derived using conditional logistic regression analysis, adjusted for disease and drug history. RESULTS: An increased risk of hip/femur fracture was observed in patients who experienced a stroke at any time before the index date (adjusted OR, 1.96; 95% CI, 1.65-2.33). The fracture risk was highest among patients who sustained a stroke within 3 months before the index date (adjusted OR, 3.35; 95% CI, 1.87-5.97) and among female patients (adjusted OR, 2.12; 95% CI, 1.73-2.59). The risk further increased among patients younger than 71 years (adjusted OR, 5.12; 95% CI, 3.00-8.75). Patients who had experienced a hemorrhagic stroke tended to be at a higher hip/femur fracture risk compared with those who had experienced an ischemic stroke. CONCLUSIONS: Stroke is associated with a 2.0-fold increase in the risk of hip/femur fracture. The risk was highest among patients younger than 71 years, females, and those whose stroke was more recent. Fall prevention programs, bone mineral density measurements, and use of bisphosphonates may be necessary to reduce the occurrence of hip/femur fractures during and after stroke rehabilitation.
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e-pub ahead of print date: 6 August 2009
Published date: 2009
Keywords:
bone density, fracture, risk factors, stroke
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Local EPrints ID: 72894
URI: http://eprints.soton.ac.uk/id/eprint/72894
ISSN: 0039-2499
PURE UUID: 6ab6bad2-7da6-44b3-ae77-244d4db1b027
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Date deposited: 24 Feb 2010
Last modified: 18 Mar 2024 02:44
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Author:
Sander Pouwels
Author:
Arief Lalmohamed
Author:
Bert Leufkens
Author:
Anthonius de Boer
Author:
Tjeerd van Staa
Author:
Frank de Vries
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